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Cancer is the most frequent cause of disease related death among adolescents and young adults (AYA) 15-39 years of age at diagnosis. [2] Adolescent and young adult (AYA) cancers represent a small proportion of overall cancer cases, and overall survival rates remain high in many developed countries. However, AYA cancers may be more likely to be diagnosed at a later stage because of delays in diagnosis due to the infrequency of disease in younger patients, as well as the larger proportion of younger Americans (compared to older Americans) who are under- or uninsured.[1]
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Relative youth is associated with lack of immunosenescence, lack of polypharmacy and/or consequences of adverse events, which may suggest increased ability to tolerate and therefore benefit from targeted immunotherapy in AYA cancer patients.
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Existing disparities research may mask similarities or differences that uniquely impact this patient population.
Our proposed analysis are two-fold.
Describe top 10 most common AYA cancers and Explore any disparities that may exist in AYA cancers.
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By sex
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By race
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By SES (County-level employment, income, poverty)
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By:
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Stage at diagnosis, tumor grade, tumor size (each as applicable)
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First course of treatment
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Lag time dx to first course of treatment
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What treatment was given
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?Measure of disease burden at diagnosis
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?Path to diagnosis
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Mortality
- Describe changes in the above between 1997-2016.
- Investigate the impact of key milestones: - ACA (2014) - Cervical Cancer vaccine (2006)
We will be mainly using descriptive statistics and data visualizations to investigate disparities among different types of cancers.
Our data will come from SEER Incidence Data, between the years of 1997 - 2016. More specifically, data from the Surveillance, Epidemiology, and End Results (SEER-18) Program (November 2018 submission) of the National Cancer Institute were used for this analysis. SEER 18 covers approximately 28% of the US population (based on the 2010 census), with data from cancer registries in California, Connecticut, Michigan, Hawaii, Iowa, New Mexico, Washington, Utah, Georgia, Alaska, Kentucky, Louisiana, and New Jersey.
From the SEER Data basically we will be looking at the following variables:
- Unemployment percentages in the County of individual
- Race and Origin
- Survival Months
- Family Poverty percentages in the County of Individual
- Median survival months
- Tables
Top 10 cancer counts by decades:
| Cancer Type | 1997-2006 (N) | 1997-2006 (%) | 2007-2016 (N) | 2007-2016 (%) | Total |
|---|---|---|---|---|---|
| Acute Lymphocytic Leukemia | 8,024 | 4.35% | 10,457 | 4.43% | 18,481 |
| Brain | 10,911 | 5.91% | 13,178 | 5.59% | 24,089 |
| Breast | 24,877 | 13.48% | 29,362 | 12.45% | 54,239 |
| Cervix | 8,543 | 4.63% | 8,836 | 3.75% | 17,379 |
| Colorectal | 7,220 | 3.91% | 9,791 | 4.15% | 17,011 |
| Hodgkin's Lymphoma | 9,890 | 5.36% | 11,594 | 4.92% | 21,484 |
| Melanoma | 18,451 | 10.00% | 19,999 | 8.48% | 38,450 |
| Non-Hodgkin's Lymphoma | 11,548 | 6.26% | 13,694 | 5.81% | 25,242 |
| Testis | 12,661 | 6.86% | 17,117 | 7.26% | 29,778 |
| Thyroid | 17,883 | 9.69% | 32,277 | 13.69% | 50,160 |
| All else | 54,557 | 29.56% | 69,516 | 29.48% | 124,073 |
| Totals | 184,565 | 100.00% | 235,821 | 100.00% | 420,386 |
- Data visualizations
- Top 10 Cancers: each year.
WHERE THE SEER DATA COMES FROM GEOGRAPHICALLY
[1] American Cancer Society. Cancer Statistics Center. Cancer Facts & Figures 2020. 2020 Special Section: Cancer in Adolescents and Young Adults. http://cancerstatisticscenter.cancer.org. Accessed April 23, 2021.
[2] DeRouen, Mindy C., et al. "Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status." Cancer Causes & Control 28.8 (2017): 841-851..